Can cancer patients be evaluated annually with PET scanning?

Can cancer patients be evaluated annually with PET scanning?

Dear OncoLink "Ask The Experts," Why can't cancer patients be evaluated annually with PET scanning? If it is simply a matter of cost, can't a patient pay for one his/herself? It would be worth the cost for the peace of mind gained.

Peeyush Bhargava, MD, Chief Fellow in the Department of Nuclear Medicine at the University of Pennsylvania, responds:

A PET scan is a diagnostic test (ordered to answer a specific question) as opposed to a screening test (ordered to try rule out a particular condition). PET scans are used in combination with other radiology procedures (MRI, CT, X-rays) to help make a diagnosis or follow a patient that has undergone treatment. They are not used as screening tests for cancer.

A good screening test needs to be safe, specific (positive only for the particular condition being screened), and make a difference in survival because it allows for early initiation of treatment. There are a number of reasons for a PET scan to have increased activity, not just cancer. If a PET scan was used to screen for cancer and increased activity was found, this may lead to undue anxiety and further unnecessary evaluations and procedures that could be harmful to the patient. Furthermore, PET scans are not helpful in all types of cancer. Thus it is not feasible to do a PET scan on everyone annually for cancer screening.
Below are the indications for FDG-PET scans (both Medicare approved and non-Medicare approved). Typically a PET scan costs between US $ 1500 to 2500. We frequently encounter patients who pay from their own pockets to get a scan when their insurance company has denied. In future, the indications for PET scans are going to increase and the cost of getting a scan would decrease."